Medication Authorization Specialist

1 day ago


Boston, Massachusetts, United States Massachusetts General Hospital Full time
Job Summary

MGH Gastroenterology is seeking a highly skilled Medication Prior Authorization Specialist to join our team. As a Medication Prior Authorization Specialist, you will be responsible for obtaining all medication prior authorizations, downloading PA requests, and entering them into CoverMyMeds. You will also be responsible for tracking patient and pharmaceutical information, resulting out PA's, documenting, and following up on all open PA's not escalated to management.

Key Responsibilities
  • Obtain all medication prior authorizations
  • Download PA requests and enter them into CoverMyMeds
  • Track patient and pharmaceutical information
  • Result out PA's, document, and follow up on all open PA's not escalated to management
  • Communicate effectively with providers and office staff through email and phone calls regarding any issue with the PA process and/or individual patients
  • Call pharmacy, patient, and insurances when needed to successfully complete PA's
  • Determine which PA's require escalation or further assistance from management
  • Complete all necessary training for EHR systems in EPIC
  • Possess a working knowledge of pharmacy processes
  • Work diligently to assist clinical and administrative teammates within the clinic
Requirements
  • High school diploma or Associates in Science in combination with 2-3 years' experience working with health insurance or in a healthcare setting
  • Outstanding customer service, written and verbal communication skills
  • Ability to prioritize and handle multiple tasks, producing high-quality work in a timely, accurate and efficient manner
  • Proficiency in the use of computers and basic software applications
  • Ability to be flexible and work within a team-focused, participative management framework
  • Medication Prior Authorization experience preferred


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